Tendon healing, edema, and resistance to flexor tendon gliding: clinical implications

Hand Clin. 2013 May;29(2):167-78. doi: 10.1016/j.hcl.2013.02.002. Epub 2013 Mar 25.


Early flexor tendon healing is characterized by peak cellular apoptosis of both inflammatory and tendon cells in the first week, followed by progressively greater tenocyte proliferation in the second and third weeks. Tenocyte apoptosis is a predominant event, but proliferation of tenocytes is minimal in the middle and late healing periods. Edematous subcutaneous tissues, edema of the tendon, the intact annular pulleys, and extensor tendons all greatly contribute to the resistance. Careful consideration of the contributing factors and dynamics offers insight into strategies to reduce repair rupture and maximize tendon gliding through surgery and postoperative motion protocols.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Apoptosis / physiology
  • Biomechanical Phenomena
  • Edema / physiopathology*
  • Finger Injuries / physiopathology*
  • Finger Injuries / surgery*
  • Friction
  • Humans
  • Reconstructive Surgical Procedures
  • Rupture / physiopathology
  • Tendon Injuries / physiopathology*
  • Tendon Injuries / surgery*
  • Tissue Adhesions / physiopathology
  • Tissue Adhesions / prevention & control
  • Wound Healing / physiology*